Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Health Insurance

44% of Employees Don’t Know Value of Health Plan Benefits

November 13, 2017 - Employers must increase their efforts to educate members about the value of their health plan benefits based on recent findings that only 44 percent of employees fully comprehend their benefits. That is the leading takeaway from research published earlier this week by Lincoln Financial Group.                                                                                                       ...


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Bipartisan Senate Compromise May Reinstate CSRs, Alter 1332 Waivers

by Thomas Beaton

Senators Lamar Alexander (R-TX) and Patty Murray (D-WH)  have floated a bipartisan deal to reinstate the ACA’s cost-sharing reductions (CSRs) and boost individual enrollment outreach in exchange for alterations to the state 1332 waiver...

Health Plan Consumers Report Insufficient Payer Communications

by Thomas Beaton

Health plans may not be effectively communicating with consumers about member  benefits and largely fail to understand their members’ health and financial needs, a survey from Healthmine found. A sample of 750 consumers enrolled in...

80% of Payers Investing in Member Engagement, Satisfaction

by Thomas Beaton

Eighty percent of health plans are focusing on improving member engagement and consumer satisfaction, according to a survey by Change Healthcare.   Member engagement is a growing opportunity for payers because of the potential improvements...

Pediatric Data Reveals Private Payer, Medicaid Spending Gaps

by Thomas Beaton

Private payers spend close to twice as much on pediatric services as Medicaid, according to a statistical brief from AHRQ, highlighting significant disparities in cost related to visit type and geographical region. Data from the 2015 Household...

90% Medicare Supplemental Plan Members Report Satisfaction

by Thomas Beaton

Over 90 percent of Medicare supplemental plan beneficiaries cited satisfaction with their healthcare coverage, according to a recent AHIP study. Findings point out ways for payers to provide consumer-friendly health plans to a growing senior...

Nevada Blue to Offer Supplemental Medicare Coverage to Members

by Thomas Beaton

On October 1, Blue Cross Blue Shield (BCBS) of Nevada members can enroll in Medicare Supplemental Innovation Plans F, G, or N that provide preventative care services and extended benefits, the payer announced earlier this week. The plans will...

Anthem to Acquire FL Medicare Advantage Organization HealthSun

by Thomas Beaton

Anthem entered into an agreement to acquire Florida-based HealthSun, a payer and integrated health system that provides care and coverage to 40,000 Medicare Advantage beneficiaries, the payer announced in a press release.   Leaders at Anthem...

Veterans Gained Coverage under ACA, but May Lose Big from Repeal

by Thomas Beaton

While the Affordable Care Act (ACA) produced significant coverage gains for veterans, currently proposed repeal actions could hit this population particularly hard, according to a study from RAND Corporation. Prior to the ACA, 9.1 percent of...

Narrow Provider Networks are 16% Cheaper for ACA Plans

by Thomas Beaton

Economists from Harvard Business School and Northeastern University found individual ACA silver plans with narrow provider networks were 16 percent cheaper for consumers and offer payers a promising savings opportunity in the commercial market....

Governors Propose Health Insurance Market Stabilization Plan

by Thomas Beaton

Eight state governors have outlined their proposals for a health insurance market stabilization plan that would control premium increases and improve competition in the federal and state health insurance exchanges. In a letter sent to Congress,...

Latest Earnings Reports Show State of Health Payers in 2017

by Thomas Beaton

At the half-year mark, payers have a good sense of how well their efforts to promote value-based care have fared and the opportunity to make the necessary adjusts where they have not. As part of the business-facing side of value-based care, payers...

Effective Steps for Health Insurance Marketing, Consumer Engagement

by Thomas Beaton

Creating and deploying effective health insurance marketing and consumer engagement plans can be difficult for payers in today’s complex purchasing landscape.   Payers must focus on building strong brands, clear messaging, and effective...

How Can Health Savings Accounts Help, Hinder Patients and Payers?

by Thomas Beaton

Health savings accounts (HSAs) have been widely discussed as lawmakers consider policy reforms, at the federal level, and have become a fixture in conversations about healthcare spending among payers and patients alike.   HSAs are consumer...

What to Look for in Health Insurance Enrollment Technology

by Thomas Beaton

Health insurance enrollment technology is designed to offer payers convenience, cost savings, and administrative ease-of-mind when it comes managing beneficiaries enrolled in health plans. Many Americans face challenges when seeking new health...

AHA to CMS: Continue Funding ACA Cost-Sharing Reductions

by Thomas Beaton

CMS should continue to fund the cost-sharing reductions (CSRs) that keep the Affordable Care Act insurance marketplaces relatively stable, the American Hospital Association (AHA) said in a comment letter. AHA asserts that should the government...

BCBS of Louisiana Offers Online Consumer Price Comparison Portal

by Thomas Beaton

In an effort to improve transparency and customer engagement, Blue Cross Blue Shield (BCBS) of Louisiana launched an online consumer price comparison portal. The portal, called SmartShopper, allows any BCBS  customer in Louisiana to compare...

Member Engagement for Payers Should Focus on Simplicity

by Jesse Migneault

For payers, an effective member engagement strategy can lead to better member health, lower claims cost, and improved product loyalty.  To achieve these goals, payers should start by identifying pain points and implementing processes that...

Narrow Insurance Networks Can Limit Options for Cancer Care

by Jesse Migneault

Cancer patients may have limited access to top-tier healthcare options if enrolled in narrow insurance networks, according to a study from the Perelman School of Medicine at the University of Pennsylvania.  Policymakers and payers have a...

Kaiser Permanente Health Plan Falls Short on Behavioral Health

by Jesse Migneault

Kaiser Permanente’s health plan does not adequately ensure that patients can access behavioral health services in a timely and effective manner, says the California Department of Managed Health Care after a routine survey.  The report...

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